Experts agree that excess sugar consumption is toxic. Among other things, it has been linked with obesity, diabetes and heart disease.
As a result, sugar-free diets have popped up and fruit has become a fall guy, with many avoiding sugar shunning the fruit bowl.
But does fruit really deserve the flak?
Fructose is a simple sugar found naturally in fruit.
Fructose, in particular, has copped criticism in the sugar debate and part of the problem is the way it is metabolised by the body.
One Yale study published earlier this year compared fructose with glucose, another simple sugar. The study found that fructose, unlike glucose, may provoke our desire for food and doesn't stimulate our satiating hormones.
Additionally, the authors said: "Increases in fructose consumption have paralleled the increasing prevalence of obesity, and high-fructose diets are thought to promote weight gain and insulin resistance."
But although fruit is the primary natural source of fructose, it is not one of the top five sources of fructose, in America at least. Fruit is not the enemy, experts say.
In a recently published article in the Journal of the American Medical Association, David Ludwig, of Harvard's school of Public Health, examines the effects of fructose.
He points out that humans virtually never consume fructose in isolation, that it has low glycemic index and says that, when consumed as fruit, it is not linked with weight gain or adverse health, regardless of how much you eat.
And while it has the additional benefit of fibre, he says that's not the whole of it.
"You can't just take an 8-ounce [250 millilitre] glass of cola and add a serving of Metamucil and create a health food," Dr Ludwig told The New York Times. "Even though the fructose-to-fibre ratio might be the same as an apple, the biological effects would be much different."
This is partly because fruit's fibre slows the sugar absorption rates.
"Four apples may contain the same amount of sugar as 24 ounces [700 millilitres] of soda, but the slow rate of absorption minimises any surge in blood sugar. Repeated surges in blood sugar make the pancreas work harder and can contribute to insulin resistance, thereby increasing the risk for Type 2 diabetes.
"If we take a nutrient-centric approach, just looking at sugar grams on the label, none of this is evident. So it really requires a whole foods view."
Melanie McGrice, accredited practising dietitian and spokeswoman for the Dietitians Association of Australia, agrees.
"It's not good that people are avoiding fruit. It's like throwing the baby out with the bathwater," she says.
She notes that as part of the new dietary guidelines released earlier this year, there was a review of 55,000 evidence-based studies. "The result showed the importance of fruit as part of a healthy diet. It significantly reduces the risk of heart disease and cancer - two of the biggest killers in Australia."
As well as being a great source of fibre, antioxidants and vitamins, it is also a prebiotic which encourages the growth of good bacteria in the digestive tract, she explains.
"The best advice is to have a variety of fruits - they contain different antioxidants, buy in season (when it's cheaper and also more nutritious) and watch for portion size - some bananas are two or three serves."
She says "about a handful" of fruit is one portion size. The recommended daily intake is two or more serves.
As for fruit in different forms, she says dried fruit is fine, but portion sizes are still based on fresh fruit. For instance, a whole pack of dried apricots might be easy to eat, but it equates to eating around 24 fresh apricots in one go. The same goes for juice.
"You are actually having a large volume of fruit," McGrice says. "Plus without the fibre, the fructose releases faster into the bloodstream yet you don't feel as full."
In his review, Ludwig concludes that while "excessive intake of refined sugar plays a significant role in the epidemics of obesity and related diseases . . . fructose in its primary natural form (whole fruit) is not associated with adverse effects up to the limits of human consumption".
- Sydney Morning Herald
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